Diabetes is a condition where the amount of glucose in your blood is too high because the body cannot use it properly. This can be because:

• your pancreas, an organ in the abdomen, does not produce any insulin, or not enough, to help glucose enter your body’s cells
• the insulin that is produced does not work properly (known as insulin resistance)

Insulin is the hormone produced by the pancreas that allows glucose to enter the body’s cells, where it is used as fuel for energy.  Glucose comes from digesting carbohydrate and is also produced by the liver. Carbohydrate comes from many different kinds of foods and drinks, including:

• starchy foods, such as:
  • bread
  • potatoes
  • rice
  • maize
  • chapattis
• fruit
• some dairy products
• sugar and other sweet foods

If you have diabetes, your body cannot make proper use of this glucose so it builds up in the blood and it can’t be used as fuel. Some of the long-term consequences of poorly controlled diabetes are:

• cardiovascular disease
• heart attack
• stroke
• renal failure
• impotence

There are two different types of diabetes – type 1 and type 2.

• Type 1 diabetes occurs when the pancreas can no longer produce insulin because the cells that produce insulin have been destroyed or no longer function. This is usually an autoimmune disease and is often diagnosed early in someone’s life
• Type 2 diabetes develops when the body is unable to produce enough insulin or the body can no longer use the insulin effectively. Type 2 diabetes often appears after the age of 40 and is more common in South Asian and black, or overweight (body mass index (BMI) of over 25 kg/m²) people

Diabetes, particularly type 2 diabetes, is becoming increasingly common due to increasing weight in the population. Diet is very important to help manage diabetes and prevent its development. 

Diabetes is controlled initially through healthy eating. When this is no longer effective, medications will be introduced. Maintaining a healthy weight and BMI (between 20 and 25kg/m²) will help with the management of diabetes that can prolong the time before starting diabetes medicines.

The aim of weight loss should be to reach a normal BMI (between 20 and 25kg/m²). There is evidence to suggest that even by losing 5% – 10% of your body weight you can reduce your risk of developing diabetes or improve your blood glucose control. 

• Calculate your BMI

Our dietitians are available in clinic to discuss healthy lifestyle, including eating and activity, with diabetic and non-diabetic patients. Advice can be given regarding:

• weight management and maintaining a healthy BMI
• what carbohydrates are and their importance in blood sugar control
• common questions, to help dispel myths around diabetes 

Metabolic syndrome

Metabolic syndrome is a combination of metabolic disorders that, together, can increase the risk of developing heart disease and diabetes. The World Health Organisation (WHO) definition for metabolic syndrome is:

“Type 2 diabetes, impaired glucose tolerance or normal glucose tolerance with insulin resistance, together with two or more of the following:

1. Elevated blood pressure (more than 130/85 mmHg or active treatment for hypertension)
2. Abdominal obesity and/or BMI >30kg/m²
3. Low HDL cholesterol (less than 1.0 in men and less than 1.2 in women)
4. High triglycerides (over 1.7mmol/l)
5. Microalbuminurea (protein losses from the urine)”

Abdominal obesity is measured by waist circumference. This can be easily done by using a tape measure around your waist, which is the mid point between your hip bone and the bottom of your ribs. 

• Measuring your waist

In clinic, the dietitian will monitor your waist circumference (the amount of fat around your abdomen), blood pressure and cholesterol levels to prevent the progression into metabolic syndrome. Modification of the diet and exercise is very important to help prevent or slow the progression of metabolic syndrome.